Case Study in Bundled Payments:
The Baptist Health System Experience

The distribution of gainshare checks to participating Baptist Health
System physicians was a 'Hallmark moment' of the CMS Acute Care Episode
(ACE) pilot, recalls Michael Zucker, senior vice president and chief development officer. The ACE pilot tested bundled payments across
specific episodes of care.

For organizations considering participation in the 2011 CMS Bundled
Payments initiative, Case Study in Bundled Payments: The Baptist Health System Experience is essential reading before filing letters of
intent and applications for CMS's new bundled payment program.

This 24-page report documents the care payment experience of Baptist Health System in the CMS ACE demonstration pilot, which aligned payment for services delivered across episodes of care or "bundled" care.

Data from the ACE demonstration helped to lay the
groundwork for the new Bundled Payments program.

A major player in the cardiac arena, having a little over
a third of the cardiac market share, Baptist Health saw
in the ACE demo an opportunity to gain market share,
align providers in quality and efficiency efforts,
and improve patient satisfaction. It signed on to be
one of five healthcare systems in the ACE pilot.

In Case Study in Bundled Payments: The Baptist
Health System Experience, Baptist Health System
Senior Vice President and Chief Development Officer
Michael Zucker, FACHE, outlines the San Antonio-
based five-hospital system's motivation for participation, the key principles of the
ACE demonstration, the challenges and benefits and success strategies and
lessons learned from the ACE demonstration — as well as the "Hallmark moment"
of distributing gainshare checks to participating providers.

Zucker provides a frank look at the challenges of structuring payments,
adjusting for severity, engaging physicians and vendors, coordinating
and negotiating services and preparing for transition to real-life
application.

Like the ACE program, the upcoming Bundled Payments program is designed
to align payments for services delivered across an episode of care,
such as heart bypass or hip replacement, rather than paying for
services separately.

The fall 2011 Bundled Payments program, greenlighted by the Patient
Protection and Affordable Care Act, outlines four broad approaches
to bundled payments. Providers will have flexibility to determine
which episodes of care and which services will be bundled together,
making it easier for providers of different sizes and readiness
to participate in this initiative.

Don't wait to order your organization's copy of The Case Study in
Bundled Payments: The Baptist Health System Experience to help
your organization prepare for CMS's new bundled payment initiative.